b Facing challenges from others

During the course of the interviews positive reports of the interpersonal relationships between participants was therefore clearly evident.

However, the Facing challenges from others concept emerged due to the recognition that at times relationships between the participants and their colleagues could be strained, particularly where stressors were prevalent.

This led one participant to use the analogy of a marriage to describe these relationships.

“On stressful days, we all, you know, going to work is like a marriage, we work together and yes it has got a little bit heated, but in a healthy nature” N 5, transcript line numbers 344-346.

The concept of interprofessional collaboration, as described in the context of a marriage, is not one noted in any of the empirical literature reviewed for the purposes of this study. However, it is possible to appreciate this analogy due to the intensity of interactions and affinity for others

demonstrated by the participants during the interviews. This reinforced the strength of the participants’ interpersonal relationships with each other, but also how they put coping strategies in place to overcome any difficulties.

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Unlike other empirical studies noted in the preliminary literature review, which suggested a presence of conflict within teams, the participants in this study reported rare occasions where they considered they were Facing challenges from others from those within their social group. Therefore, due to the emotive definitions of the term “conflict” as relating to turf wars or fights between parties, the use of this within the literature was reviewed. Unlike in many extant studies, I considered it not to be reflective of the relationships within this study as there was no evidence from participants that this occurred significantly within their services. I therefore instead perceived the term disharmony was to be more

characteristic of the responses to represent situations of tension or unrest that were mentioned during the interviews between in-group members. Participants suggested instead that they discussed any state of

disharmony between themselves to put strategies in place to achieve an outcome of consensus.

“if you have a difference of opinion, seeing how it can be managed, seeing which one is more feasible, which is more realistic and

obviously discussing it with the patient as well” N4, transcript line

numbers 161-164.

This use of discussion as a coping strategy was reported to be present within all the services in this study and was considered a contributory factor in resolving difficulties to manage these situations through the process of interacting with colleagues to achieve consensus. This was aided by the strength of the interpersonal relationships developed between the in-group members.

“We have got those relationships and it’s never going to turn into confrontation” OT 6, transcript line numbers 126-127.

Upon comparing the data, an interesting finding from all the services was that the participants highlighted that managing the effects of disharmony

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was time consuming and impacted on the resources available to undertake their operational role. Due to the demands on them

professionally, the dysfunction this created was therefore perceived by the participants to have a wider impact on their overall performance. To manage this, participants reported taking time, which was coded as

Making time for discussion to proactively resolve any issues that arose that may impact on how the team functions.

“Generally the team works really well and we all work well together. If there are any problems then we will all discuss it together within the team” PT 6, transcript line numbers 297-299.

In doing so, it may be perceived that the intent of this discussion was to reach agreement in how to manage specific situations.

Although situations of disharmony were reported as infrequent, it was noted that issues Affecting relationships and Putting barriers up were more likely to occur at times of stress or when there were pressures of high demand and limited capacity for the service.

On these occasions participants stated they referred back to their personal knowledge of each individual, Engaging with others and Listening to each other, both codes identified within “Awareness of

others”, to reflect on how people would normally present. They

suggested talking to colleagues to offer support in managing the situation should difficulties present. This reinforced the extent of cohesion between the concepts, but also the individual group members.

“I think everyone is very supportive of each other. There are always times in the team when due to sickness and that kind of thing

people do get stressed but it is never because we are not working as a team but more because of workload and resources” PT 7,

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This was interpreted as reinforcing a proactive approach to the management of interpersonal relationships. The concept of Facing challenges from others may be perceived to impact on the

effectiveness of these relationships, however within this study this

concept was not necessarily always perceived as a negative issue. It was instead reported that challenge did allow the opportunity to review how individuals worked.

“I think in everything we will have disagreements, different opinions but I think in everything that helps the discussion; I don’t think that is anything you know. It is getting people to look at the different ways that they work to as to how they work. And I find the majority of time it is still respected” N 5, transcript line numbers 340-344.

Reflecting on practice in this way, I interpreted this as suggesting that coping strategies were put in place to manage dysfunctional situations and disharmony between individuals. A comparison of the data between the services, and also individuals, suggested the aim was to achieve a continuation of consistency for how the service operated, creating a sense of order and stability.

The desire to achieve this appeared to be strong between the participants suggesting that, due to the demands they perceived to be placed on them, participants did not relish any desire to fight between themselves, instead seeking a peaceful co-existence.